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Delivery of azithromycin to Chlamydia trachomatis-infected polarized human endometrial epithelial cells by

T R Paul1, S T Knight, J E Raulston

  • 1Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill 27599-7290, USA.

Insights

Polymorphonuclear leucocytes (PMN) deliver azithromycin to effectively damage Chlamydia trachomatis within host cells. This antibiotic delivery by PMN reduces infectious progeny, demonstrating a novel therapeutic strategy for chlamydial infections.

Area of Science:

  • Microbiology
  • Immunology
  • Pharmacology

Background:

  • Chlamydia trachomatis infections are a significant global health concern, often requiring effective antibiotic treatment.
  • Polymorphonuclear leucocytes (PMN) play a crucial role in host defense against bacterial pathogens.
  • Azithromycin is a key antibiotic used to treat chlamydial infections.

Purpose of the Study:

  • To investigate the in-vitro efficacy of azithromycin-loaded PMN in targeting Chlamydia trachomatis within human endometrial epithelial cells.
  • To determine if PMN can deliver bioactive azithromycin to chlamydial inclusions.
  • To assess the impact of PMN-mediated antibiotic delivery on chlamydial viability and progeny formation.

Main Methods:

  • Development of an in-vitro model using polarized human endometrial epithelial (HEC-1B) cells infected with Chlamydia trachomatis.
  • Loading of PMN with azithromycin and assessment of their chemotaxis towards infected cells.
  • Microscopic evaluation of chlamydial inclusions and morphological changes following exposure to azithromycin-loaded PMN.
  • Quantification of infectious progeny to confirm the lethal effect of azithromycin.

Main Results:

  • PMN efficiently migrated to and between infected HEC-1B cells, particularly at 36-48 hours post-infection.
  • Azithromycin-loaded PMN induced significant morphological damage to chlamydial inclusions, including deformed reticulate bodies and excessive outer membrane vesicles.
  • Increased PMN-delivered azithromycin led to the formation of large cell envelope 'ghosts' and a reduction in viable infectious progeny.
  • PMN not loaded with azithromycin caused less direct damage to chlamydiae but still reduced progeny, potentially via host cell disruption.

Conclusions:

  • PMN can effectively transport and deliver azithromycin in a bioactive form to chlamydial inclusions in infected endometrial epithelial cells.
  • PMN-mediated delivery of azithromycin results in the destruction of Chlamydia trachomatis and a significant reduction in infectious progeny.
  • This study highlights a potential novel strategy for enhancing antibiotic efficacy against chlamydial infections through PMN-mediated drug delivery.

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